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August 2014 Moms
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Pregnancy as a pre existing condition

bmcoburnbmcoburn member
in August 2014 Moms
So I've read that if you don't have insurance when you conceive (sometimes a few months before you conceive) some insurance companies won't cover your pregnancy costs. They will still take you on and cover any other illness or injury that comes up, but not pregnancy if it's confirmed to be before your coverage started. My husband was active duty military but obviously our tricare ended when he got out. He got a new job but was considered a temp while going through training for it. As of December 1st he is supposed to receive benefits from his job but of course I got pregnant during the couple months we didn't have insurance coverage! I work full time too but declined insurance because my husbands should be better. Has anyone else dealt with this or have any knowledge of it first hand? I called my obgyn and talked to billing and they said they don't think insurance companies can do that anymore. I'm not sure why that is? Something to do with the healthcare reform maybe? Anyway, just curious if anyone knows anything more about it.
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Re: Pregnancy as a pre existing condition

  • jlynn62511jlynn62511 member
    This may be different but when I was looking into short term disability, the guy told me to not go to the doctor until after the insurance starts. So I would make sure you make your appointment for after December 1st.  

    Can you check with your DH's employer?  Maybe someone is HR would know the answer. 

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  • violajackviolajack member
    edited December 2013
    As of January 1st, ACA compliant plans cannot refuse coverage of a preexisting condition. I confirmed this with my broker as my current awesome plan has been canceled for not being ACA compliant. I have to buy a new plan as of Jan 1 which happens to cost more than twice as much as what I pay now, but hey, at least it will cover the pregnancy (which totally would have been equally covered if I could have just kept my old plan, grrrrrr). 

    ETA, my first appointment will be Jan 2nd, but that's due to travel rather than insurance crap. 

    Also, the broker I'm going through is getting me a plan direct with blue cross, which is cheaper than their exchange plans. 
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  • bmcoburnbmcoburn member
    Thanks violajack. We will have blue cross as well, that's what my husbands employer offers. They cover a good chunk of the cost, not sure how much. But I'm sure it will still be expensive. I guess it's better than paying thousands in medical bills though!
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  • bmcoburnbmcoburn member
    My first appointment is December 20th but it's only $100 and they said if we don't have our insurance cards yet, they can bill the company after the second appointment and reimburse the out of pocket cost.
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  • seventhumbsseventhumbs member
    Yes. Obamacare makes it illegal for insurance companies to consider pregnancy a pre-existing condition. However, if your plan was one that was recently "canceled" because it did not meet the requirements of Obamacare, but was then subsequently extended for another year (because people were so ticked off that their plans were being canceled), then pregnancy MIGHT still be considered a pre-existing condition under your plan.

    It's insane that pregnancy would be considered a pre-existing condition in the first place, but that's for another rant on another day...




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  • bmcoburnbmcoburn member
    @seventhumbs We didn't have insurance...well we had tricare, but for the past couple months we've been without coverage. I assume we will have to choose one of the new plans since we are starting fresh, not extending an existing plan.
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  • Jmburgess330Jmburgess330 member
    Ugh. Same boat here! Got short term disability to help cover maternity leave and can't even call the dr and schedule an appt until Jan 1st. From what I can calculate, I will be 8 weeks on Janary 7th...I'm hoping they can get me in quickly! We are planning on telling my parents in the next couple weeks, but don't want to tell anyone else until after the first ultrasound and we hear the heartbeat. So frustrating!
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